CSB OF EAST CENTRAL GA (NPI# 1194056879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1194056879 |
Entity Type | Organization |
Organization Name | CSB OF EAST CENTRAL GA |
Other Organization Name | GULLEY PCH |
Practice Address |
236 Main St Warrenton GA 30828-8100 |
Mailing Address |
3421 Mike Padgett Hwy Augusta GA 30906-3815 |
Practice Telephone | 7064324858 |
Practice Fax Number | 7064323780 |
Enumeration Date | 2010-01-20 |
Last Update Date | 2010-01-20 |
Authorized Official Name | WANDA JESSIE (BILLING MANAGER) |
Authorized Official Telephone | 7064324858 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | 000927693AF | 05 |
Other Name | Type Code |
---|---|
GULLEY PCH | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467013821 | Csb of East Central Ga | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5101 Parnell Way, Martinez, GA 30907-8896 | 2019-06-26 |
1811436512 | Csb of East Central Ga | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4008 Ramswood Dr, Hephzibah, GA 30815-5849 | 2017-02-15 |
1508305285 | Csb of East Central Ga | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3126 Richmond Hill Rd, Augusta, GA 30906-4754 | 2017-02-15 |
1447798707 | Csb of East Central Ga | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 355 Bobwhite Trl, Grovetown, GA 30813-5886 | 2017-02-07 |
1346565926 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3015 Manchester Dr, Hephzibah, GA 30815-7166 | 2010-04-07 |
1700101391 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2006 Country Place Dr, Augusta, GA 30906-8732 | 2010-04-07 |
1588995112 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 386 Tower Rd, Augusta, GA 30907-8750 | 2010-01-21 |
1881925410 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3461 Camak Dr, Augusta, GA 30909-9433 | 2010-01-21 |
1053642686 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2115 Ashley Dr, Augusta, GA 30906-5085 | 2010-01-21 |
1679804215 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2208 Walden Dr, Augusta, GA 30904-6508 | 2010-01-21 |
Street Address |
236 MAIN ST |
City | WARRENTON |
State | GA |
Zip Code | 30828-8100 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679093645 | Community Health Care Systems, Inc | Pharmacy | 1008 Atlanta Highway, Chcs, Inc Pharmacy, Warrenton, GA 30828 | 2017-06-21 |
1225350291 | Point of Need, Inc | Durable Medical Equipment & Medical Supplies | 1186 Atlanta Highway #707, Warrenton, GA 30828 | 2010-02-18 |
1952486888 | Rebecca Lowe | Licensed Practical Nurse | 510 Legion Drive, Warrenton, GA 30828 | 2006-10-26 |
1164507661 | Julia Marie Veasey | Registered Nurse | 565 Legion Drive, Warrenton, GA 30828 | 2006-10-25 |
1336446962 | Warren County Board of Education | Local Education Agency (LEA) | 85 Edward Ricketson Jr St, Warrenton, GA 30828-0228 | 2011-02-17 |
1376535278 | Community Health Care Systems,inc. | Clinic/Center | 1008 Atlanta Hwy, Warrenton, GA 30828-0312 | 2005-08-17 |
1154622769 | Miek C. Johnson | Physician Assistant | 1008 Atlanta Hwy, Tri-county Health System, Inc., Warrenton, GA 30828-0312 | 2010-11-12 |
1467783001 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 99 Pineview Ave, Warrenton, GA 30828-2639 | 2010-01-21 |
1790299386 | Marcus Dawson | Psychologist | 498 Hudgeons Rd, Warrenton, GA 30828-5444 | 2017-11-19 |
1700946852 | Ar Mediccal LLC | Clinic/Center | 450 Main Street, Warrenton, GA 30828-8108 | 2006-12-11 |
Find all providers in zip 30828 |
Taxonomy Code | 320600000X |
Grouping | Residential Treatment Facilities |
Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225440480 | Reid Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 191 Railroad Lane, Warrenton, NC 27589 | 2014-05-22 |
1144669979 | Goode Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 391 Snowhill Road, Warrenton, NC 27589 | 2013-06-14 |
1588002307 | Walker Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1198 Dr Martin Luther King Jr Blvd, Warrenton, NC 27589-9173 | 2013-06-14 |
1467783001 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 99 Pineview Ave, Warrenton, GA 30828-2639 | 2010-01-21 |
1508985193 | Warren County Handicapped Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 703 1st St, Warrenton, MO 63383-2606 | 2007-03-28 |
1437279809 | Warren County Handicapped Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 703 1st St, Warrenton, MO 63383-2606 | 2007-03-30 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437764925 | Calveina Forde | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 538 Country Lake Dr, Mcdonough, GA 30252-2683 | 2020-09-10 |
1730715814 | Tyler Rose | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 116 South Mill Creek Court, Woodstock, GA 30188 | 2020-03-20 |
1023677713 | Earlean Blackwell | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1865 Waldrep Cir Se, Marietta, GA 30060-4927 | 2019-06-06 |
1629535216 | Carpenter Host Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 806 Grady Ave N, Douglas, GA 31533-4812 | 2019-03-01 |
1700354859 | View Point Health | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 160 Longstreet Cir, Oxford, GA 30054-2244 | 2018-11-07 |
1760950901 | View Point Health | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2116 Tudor Castle Cir, Decatur, GA 30035-2158 | 2018-11-06 |
1144747437 | Willie Mae Berry Pugh | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2013 Teal Court, Hephzibah, GA 30815 | 2017-08-28 |
1881116721 | Springhill Manor Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 600 Spring Hill Drive, Covington, GA 30016 | 2017-07-12 |
1093175283 | Peaceful River Residential Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 746 Rudgate Rd, Columbus, GA 31904-2929 | 2016-03-01 |
1548649494 | Prestige Community Living Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2328 Bigwood Trl, Atlanta, GA 30349-9049 | 2015-05-26 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.